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Advanced MRI Technique Offers New Approach for Diagnosing Diabetic Kidney Disease

By MedImaging International staff writers
Posted on 14 Jun 2023

Image: The 23Na MRI technology has unveiled new possibilities of diagnosing and elucidating diseases mechanisms (Photo courtesy of Niigata University)

Albuminuria has been the gold standard test for predicting the onset of diabetic kidney disease. However, detecting albuminuria alone has limited sensitivity and specificity in cases of end-stage renal failure with a reduced estimated glomerular filtration rate. This is corroborated by several studies indicating that about half of type 2 diabetes patients who developed kidney dysfunction exhibited no prior albuminuria. Now, a new study suggests that combining the evaluation of sodium concentration using 23Na MRI with urinary albumin measurement, commonly used in diabetic testing, could enable early diagnosis of tubular abnormalities in diabetic kidney disease and selection of treatment.

The kidney plays a significant role in the excretion and reabsorption of sodium. It possesses mechanisms such as the countercurrent multiplication system, which facilitates efficient water reabsorption, and the creation of an osmotic gradient by sodium ions from the cortex to the medulla. Numerous studies have explored channels and transporters involved in renal sodium metabolism, although the changes in the kidney's total sodium amount and distribution demand further investigation. 23Na MRI, which images 23Na as opposed to the clinically applied 1H in standard MRI, visualizes metabolic shifts in sodium. The advanced 23Na MRI technique can noninvasively assess the distribution of sodium throughout the kidney and assess changes in the countercurrent multiplication system.

There are earlier reports of 23Na MRI studies but capturing sodium concentrations equivalent to physiological saline and clearly visualizing them in MRI has proven challenging. This is due to the relatively small amount of sodium in vivo compared to hydrogen, resulting in exceedingly minute signal values. In the study, researchers at Niigata University (Niigata, Japan) refined the newly developed 23Na MRI to image mouse kidneys, allowing for detailed and clear imaging. The study utilized 6-week-old diabetic model mice (db/db mice) in an early stage when kidney tissue damage was not evident and imaged the kidneys using a 9.4 Tesla vertical magnet MRI device optimized by the research team. 23Na-visualization images revealed weakened formation of the countercurrent multiplication system in the kidney, compared to control mice.

23Na MRI is capable of revealing metabolic changes in renal sodium, potentially facilitating a more comprehensive understanding of the pathophysiology of not only diabetic kidney disease but also dehydration and certain types of hypertension linked to sodium metabolism. In the future, the researchers aim to explore whether these findings can assist in diagnosing other diseases. Furthermore, the successful detailed visualization of mouse kidneys suggests the possibility of broadening the target organs. As these research findings accumulate, it may pave the way for the clinical application of 23Na MRI.

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68 (33.855438232422): SELECT fid FROM jos_deeppockets WHERE id=294797553 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294797553 AND published='1' LIMIT 1

69 (28.848648071289): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (241.99485778809): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 1072.1683502197): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (741.00494384766): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (40.054321289062): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (28.133392333984): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.040740966797): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (185.01281738281): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (91.075897216797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (60.796737670898): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (261.06834411621): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (550.0316619873): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (231.02760314941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

105 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

106 (97.990036010742): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797553 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (91.075897216797): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797553 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

109 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

110 (84.877014160156): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797553 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (468.96934509277): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294797553 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (555.99212646484): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (326.87187194824): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

115 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

116 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

117 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

118 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

119 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

120 (239.13383483887): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 180260.89668274): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (!!!!! 2278.0895233154): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

123 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

124 (439.16702270508): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797553 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797553 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1982357.0251465): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (131.84547424316): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 2228.9752960205): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (267.02880859375): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (!!!!! 1877.0694732666): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (242.94853210449): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (!!!!! 1761.9132995605): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (82.969665527344): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (314.95094299316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (334.9781036377): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (186.92016601562): SELECT name FROM jos_deeppockets WHERE id=212

136 (53.882598876953): SELECT name FROM jos_deeppockets WHERE id=212

137 (577.21138000488): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (522.13668823242): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (96.797943115234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

140 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

141 (!!!!! 12320.995330811): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 2403.0208587646): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797553 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (!!!!! 2731.0848236084): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294797553 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (537.87231445312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (801.08642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (!!!!! 2073.0495452881): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

147 (372.88665771484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

148 (!!!!! 1708.0307006836): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (!!!!! 2000.093460083): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

150 (!!!!! 1032.1140289307): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

151 (!!!!! 2434.0152740479): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294797553 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294797553 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (!!!!! 1076.9367218018): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

153 (180.00602722168): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

154 (!!!!! 1140.832901001): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (183.8207244873): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

156 (324.01084899902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294797553 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294797553 AND published='1' LIMIT 1

157 (!!!!! 1573.0857849121): select jos_twitters.link from jos_twitters where cat=10

158 (79.870223999023): select jos_facebook.link from jos_facebook where cat=10

159 (46.014785766602): select jos_google_plus.link from jos_google_plus where cat=10

160 (49.114227294922): select jos_linkedin.link from jos_linkedin where cat=10

161 (368.11828613281): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2483.1295013428): insert into jos_banners_delta values (14615,'2025-04-30 09:10:39','18.191.157.31','view'),(14202,'2025-04-30 09:10:39','18.191.157.31','view'),(14203,'2025-04-30 09:10:39','18.191.157.31','view')

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